Provider Demographics
NPI:1417318064
Name:CORE SOLUTIONS PHYSICAL THERAPY, LLC.
Entity Type:Organization
Organization Name:CORE SOLUTIONS PHYSICAL THERAPY, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILOPENA
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:757-286-0544
Mailing Address - Street 1:524 INDEPENDENCE BLVD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-2221
Mailing Address - Country:US
Mailing Address - Phone:757-460-2522
Mailing Address - Fax:757-460-3810
Practice Address - Street 1:524 INDEPENDENCE BLVD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-2221
Practice Address - Country:US
Practice Address - Phone:757-460-2522
Practice Address - Fax:757-460-3810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-10
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305005569225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty